Provider Demographics
NPI:1710964150
Name:MERCY AMBULANCE SERVICE
Entity Type:Organization
Organization Name:MERCY AMBULANCE SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT AND CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:
Authorized Official - Last Name:APELSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:617-202-6106
Mailing Address - Street 1:PO BOX 1988
Mailing Address - Street 2:
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-0017
Mailing Address - Country:US
Mailing Address - Phone:617-202-6106
Mailing Address - Fax:617-202-6107
Practice Address - Street 1:9 BRISTOL DR
Practice Address - Street 2:
Practice Address - City:EASTON
Practice Address - State:MA
Practice Address - Zip Code:02375-1109
Practice Address - Country:US
Practice Address - Phone:617-202-6106
Practice Address - Fax:617-202-6107
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3047341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA1720953Medicaid
MAAM0166Medicare ID - Type UnspecifiedMEDICARE PROVIDER #